title: Differential diagnosis of intracranial meningiomas based on magnetic resonance spectroscopy.
abstract: OBJECTIVE
  To determine in vivo magnetic resonance spectroscopy (MRS) characteristics of intracranial meningiomas and to assess MRS reliability in meningioma grading and discrimination from tumours of similar radiological appearance, such as lymphomas, schwannomas and haemangiopericytomas.
  
  
  METHODS
  Analysis of spectra of 14 patients with meningiomas, 6 with schwannomas, 2 with lymphomas, 2 with haemangiopericytomas and 17 control spectra taken from healthy hemispheres.
  
  
  RESULTS
  All the patients with meningiomas had a high Cho signal (long TE). There were very low signals of Naa and Cr in the spectra of 10 patients. A reversed Ala doublet was seen only in 2 cases. Four patients had a negative Lac signal, whereas 3 had high Lac-Lip spectra. Twelve spectra showed high Cho signals (short TE). In one case the Cho signal was extremely low. All spectra displayed a very low Cr signal, but high Glx and Lac-Lip signals. Ala presence was found only in 3 patients. The mean Cho/Cr ratio (PRESS) was 5.97 (1.12 in normal brain, p < 0.05). Lac-Lip was present in all the meningiomas (STEAM). The Ala signal was seen only in 2 spectra with long TE and in 3 sequences of the short TE sequences. There were both β/γ-Glx and α-Glx/glutathione signals in all 14 meningiomas.
  
  
  CONCLUSIONS
  MRS is unable to discriminate low and high grade meningiomas. The method seems to be helpful in discriminating lymphomas (absent Glx signal), schwannomas (mI signal in the short TE sequences) and haemangiopericytomas (presence of mI band) from meningiomas.
authors.affiliation: Department of Neurosurgery and Oncology of the Central Nervous System, Medical University of Lodz, Łódź. dariusz.jaskolski@umed.lodz.pl
authors.forename: D J
authors.initials: DJ
authors.lastname: Jaskólski
authors.forename: J
authors.initials: J
authors.lastname: Fortuniak
authors.forename: L
authors.initials: L
authors.lastname: Stefańczyk
authors.forename: A
authors.initials: A
authors.lastname: Majos
authors.forename: W
authors.initials: W
authors.lastname: Gajewicz
authors.forename: W
authors.initials: W
authors.lastname: Papierz
authors.forename: P P
authors.initials: PP
authors.lastname: Liberski
authors.forename: B
authors.initials: B
authors.lastname: Sikorska
mesh_terms: D000328:Adult; D000368:Aged; D001931:Brain Mapping / Q000379:methods; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006393:Hemangiopericytoma / Q000175:diagnosis; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008579:Meningioma / Q000175:diagnosis*; D008875:Middle Aged; D009442:Neurilemmoma / Q000175:diagnosis; D055815:Young Adult